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https://www.readbyqxmd.com/read/28742223/impact-and-implementation-of-a-sustainable-regional-telestroke-network
#1
Annemarei Ranta, Jeremy Lanford, Suzanne Busch, Carolyn Providence, Ivan Iniesta, Ian Rosemergy, Andrew Wilson, Pietro Cariga, Victoria Richmond, John Gommans
INTRODUCTION: Telestroke uses videoconferencing (VC) technology to allow off-site experts to provide stroke thrombolysis decision support to less experienced front line clinicians. This project aimed to assess the impact of a new telestroke service on thrombolysis rates and door-to-needle times in participating provincial hospitals and service resources to aid transition to a sustainably telestroke service. METHODS: This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'postr' (June 2016 to December 2016) implementation outcomes...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28741744/thermal-suit-in-preventing-unintentional-intraoperative-hypothermia-during-general-anaesthesia-a-randomized-controlled-trial
#2
S-L Lauronen, M-L Kalliomäki, A J Aho, J Kalliovalkama, J M Riikonen, M-T Mäkinen, H M Leppikangas, A M Yli-Hankala
BACKGROUND: Unintentional perioperative hypothermia causes serious adverse effects to surgical patients. Thermal suit (T-Balance(®) ) is an option for passive warming perioperatively. We hypothesized that the thermal suit will not maintain normothermia more efficiently than conventional cotton clothes when also other preventive procedures against unintentional hypothermia are used. METHODS: One hundred patients were recruited to this prospective, randomized trial...
July 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28741690/health-care-resource-utilization-before-and-after-perampanel-initiation-among-patients-with-epilepsy-in-the-united-states
#3
Edward Faught, François Laliberté, Zhixiao Wang, Victoria Barghout, Batool Haider, Dominique Lejeune, Guillaume Germain, Jiyoon Choi, Aneesha Wagh, Mei Sheng Duh
OBJECTIVE: The purpose of this study was to evaluate changes in health care resource utilization following the initiation of perampanel for the treatment of epilepsy in the United States. METHODS: Health care claims from Symphony Health's Integrated Dataverse database between December 2012 and November 2015 were analyzed. Patients newly initiated on perampanel, having ≥1 epilepsy (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 345...
July 25, 2017: Epilepsia
https://www.readbyqxmd.com/read/28741010/perception-of-a-single-session-pre-in-vitro-fertilisation-counselling-service-and-attitudes-towards-support-group-a-survey-of-patients-in-singapore
#4
Gaik Suan Lim, Reshmi Karayan Kayanoth, Birit Fp Broekman, Cornelia Yi Chee
INTRODUCTION: This study aimed to investigate patients' evaluation of a compulsory pre-in vitro fertilisation (IVF) counselling session in Singapore and determine their attitudes towards attending a support group during IVF treatment. METHODS: 464 patients due to undergo their first IVF treatment were recruited at the Clinic for Human Reproduction, National University Hospital, Singapore. All patients attended a counselling session conducted by a clinical psychologist trained in infertility counselling prior to IVF treatment...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28739573/quality-assurance-audit-of-technique-failure-and-90-day-mortality-after-program-discharge-in-a-canadian-home-hemodialysis-program
#5
Nikhil Shah, Frances Reintjes, Mark Courtney, Scott W Klarenbach, Feng Ye, Kara Schick-Makaroff, Kailash Jindal, Robert P Pauly
BACKGROUND AND OBJECTIVES: Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28739535/importance-and-feasibility-of-transitional-care-for-children-with-medical-complexity-results-of-a-multi-stakeholder-delphi-process
#6
JoAnna K Leyenaar, Paul A Rizzo, Dmitry Khodyakov, Laurel K Leslie, Peter K Lindenauer, Rita Mangione-Smith
BACKGROUND: Children with medical complexity (CMC) account for disproportionate hospital utilization and adverse outcomes following discharge, and several gaps exist regarding the quality of hospital-to-home transitional care for this population. We conducted an expert elicitation process to identify important and feasible hospital-to-home transitional care interventions for CMC from the perspectives of parents and healthcare professionals. METHODS: We conducted a two-round electronic Delphi process to identify important and feasible transitional care interventions...
July 21, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28739223/decreased-mortality-in-patients-prescribed-vancomycin-after-implementation-of-antimicrobial-stewardship-program
#7
Erin L Conway, John A Sellick, Amy Horey, Kristen Fodero, Michael C Ott, Michael P Krajewski, Kari A Mergenhagen
BACKGROUND: The impact of an antimicrobial stewardship program (ASP) on 30-day mortality rates was evaluated in patients prescribed vancomycin in a Veterans Affairs hospital. METHODS: A retrospective chart review of patients receiving a minimum of 48 hours of vancomycin during October 2006-July 2014. A multivariate logistic regression analysis was used to determine predictors of mortality. Interventions of the ASP consist of appropriate antibiotic selection, dosing, microbiology, and treatment duration...
July 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#8
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#9
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737141/designing-and-validation-of-a-hindi-language-parent-self-report-developmental-screening-tool
#10
Rahul Jain, Anshita Arora, Rohit Anand, Shahzadi Malhotra, Medha Mittal, Monica Juneja
AIM: To design and validate Hindi-language parent self-report developmental screening questionnaires for 9-month and 18-month-old Indian children. DESIGN: Cross-sectional study. SETTING: Tertiary-care pediatric hospital from April 2014 to March 2016. PARTICIPANTS: In each age group (9-month and 18-month), 45 children were enrolled for designing of questionnaires (30 for obtaining parental observations of current development and 15 for pre-testing)...
July 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28737101/intervention-to-prevent-falls-community-based-clinics
#11
Dorothy I Baker, Linda Leo-Summers, Terrence E Murphy, Barbara Katz, Beth A Capobianco
PURPOSE: The purpose of this study was to document results of State funded fall prevention clinics on rates of self-reported falls and fall-related use of health services. METHODS: Older adults participated in community-based fall prevention clinics providing individual assessments, interventions, and referrals to collaborating community providers. A pre-post design compares self-reported 6-month fall history and fall-related use of health care before and after clinic attendance...
July 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#12
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#13
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 19, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#14
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#15
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729319/accelerated-enhanced-recovery-following-minimally-invasive-colorectal-cancer-surgery-recovermi-a-study-protocol-for-a-novel-randomised-controlled-trial
#16
Brandee A Price, Brian K Bednarski, Y Nancy You, Meryna Manandhar, E Michelle Dean, Zeinab M Alawadi, B Bryce Speer, Vijaya Gottumukkala, Marla Weldon, Robert L Massey, Xuemei Wang, Wei Qiao, George J Chang
INTRODUCTION: Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728783/enhanced-recovery-pathway-versus-standard-care-in-patients-undergoing-video-assisted-thoracoscopic-lobectomy
#17
Alessandro Brunelli, Caroline Thomas, Padma Dinesh, Andrew Lumb
OBJECTIVE: The objective of this study was to compare outcomes after video-assisted thoracoscopic lobectomy or segmentectomy before and after introduction of an enhanced recovery program. METHODS: Data from 600 patients undergoing video-assisted lobectomy or segmentectomy between April 2014 and January 2017 were analyzed. A comparative analysis was performed between patients undergoing operation before (365 patients) and after (235 patients) the start of the enhanced recovery program...
June 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28728570/health-promotion-interventions-for-community-dwelling-older-people-with-mild-or-pre-frailty-a-systematic-review-and-meta-analysis
#18
Rachael Frost, Celia Belk, Ana Jovicic, Federico Ricciardi, Kalpa Kharicha, Benjamin Gardner, Steve Iliffe, Claire Goodman, Jill Manthorpe, Vari M Drennan, Kate Walters
BACKGROUND: Mild or pre-frailty is common and associated with increased risks of hospitalisation, functional decline, moves to long-term care, and death. Little is known about the effectiveness of health promotion in reducing these risks. This systematic review aimed to synthesise randomised controlled trials (RCTs) evaluating home and community-based health promotion interventions for older people with mild/pre-frailty. METHODS: We searched 20 bibliographic databases and 3 trials registers (January 1990 - May 2016) using mild/pre-frailty and associated terms...
July 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28727714/3d-morphometric-analysis-of-normal-sacroiliac-joints-a-new-classification-of-surface-shape-variation-and-the-potential-implications-in-pain-syndromes
#19
Mary Kristen Jesse, Christopher Kleck, Adam Williams, Brian Petersen, Deborah Glueck, Kimberly Lind, Vikas Patel
BACKGROUND: Normal sacroiliac (SI) joints vary widely in shape, and it is unclear whether SI joint morphology plays a role in the development of pain. To answer this question, we used 3D-CT surface rendering to image healthy study participants and used the resulting images to develop a classification system for SI joint morphology. In a case-control study comparing health research participants to patients with SI pain, we assessed whether the classification of SI joint morphology was associated with pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727491/impact-of-point-of-care-xpert-mtb-rif-on-tuberculosis-treatment-initiation-a-cluster-randomised-trial
#20
Richard J Lessells, Graham S Cooke, Nuala McGrath, Mark P Nicol, Marie-Louise Newell, Peter Godfrey-Faussett
RATIONALE: Point-of-care (POC) diagnostics have potential to reduce pre-treatment loss to follow-up and delays to initiation of appropriate TB treatment. OBJECTIVE: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: A cluster randomised trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomised to two strategies (i) Xpert performed at district hospital laboratory (ii) POC Xpert performed at primary health care clinic...
July 20, 2017: American Journal of Respiratory and Critical Care Medicine
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